Step 1: Consultation
After a comprehensive consultation with one of our radiation oncologists that specializes in SRS, the appropriate imaging studies will be ordered to best visualize the tumor. Typically this is an MRI that is performed with a special SRS protocol. Overall patient management and imaging studies are generally reviewed at our many multidisciplinary tumor boards where input is obtained from staff radiologists, pathologists, surgeons, and medical oncologists.

Step 2: Treatment Planning
Under the guidance of the neurosurgeon and radiation oncologist, a treatment plan is designed that is best for you. Unlike other radiosurgery treatments, the CyberKnife® and Trilogy® Systems do not require patients to be fitted with a rigid and invasive head frame. Instead, you will receive a custom-fitted mesh mask designed to keep your head and neck still during treatment, which allows for precise targeting of your tumor. While wearing the mask, a CT scan of the brain will be performed in the department of radiation oncology for treatment planning. If an MRI was previously performed to optimally define the exact size, shape and location of your brain tumor, it is then fused to these CT images by treatment planning system. This fusion technology allows precise anatomical visualization of the tumor. Using the imaging data, your radiation oncologist and neurosurgeon will determine the precise volume of tumor to be targeted by radiation, and identify critical normal structures in the brain where radiation should be minimized, allowing for the delivery of a safe and accurate radiation treatment to your brain tumor.

Step 3: The Treatment
A comprehensive treatment plan will be formed by the radiation oncologist, SRS physicist, and neurosurgeon. The patient will then be brought into the CyberKnife® or Trilogy® treatment room and positioned on the treatment machine. You will wear your custom-fitted mask during treatment to ensure accurate localization of the tumor. The treatment is then delivered under constant monitoring by our staff. During CyberKnife treatment, the system’s computer-controlled robot will move around your body to various locations to delivery the radiation treatment precisely to your tumor, as you rest and relax on the table. The radiation is generally delivered in one to five treatment sessions, over the course of a week.

Step 4: Discharge
Upon completing the treatment, the custom-fitted mask is removed, and the patient is then discharged to home. SRS does not require an overnight hospital admission. The treatment is also painless. The entire procedure is performed in a single day and there is generally no recovery time, so that there is little interruption in your daily normal activities. Your radiation oncologist will review all possible side-effects before and after your treatment, and will review with you the plan for follow-up appointments after your treatment.